Gov’t launches US-designed family planning program

MANILA, Philippines—The government has started implementing a new family planning marketing strategy designed by the United States Agency for International Development (USAID).

The “May Plano Ako” program, conceptualized by the USAID’s Health Promotion and Communication Project, or HealthPRO, is in line with the country’s Millennium Development Goals, or MDGs, especially those on population control and reproductive health.

May Plano Ako “targets not only women but also men and young people” on the importance of family planning and contraceptive use, according to a top official of the Department of Health (DoH).

Unlike previous family planning initiatives of the DoH, which were “sporadic and small-scale,” the new program will be “unified, national and comprehensive,” according to USAID and DoH program materials furnished the Inquirer.

The US Embassy in Manila has acknowledged Washington’s active role in the Philippine government’s family planning initiatives.

In a text message, Wossie Mazengia, the US Embassy deputy spokesperson, told the Inquirer that the USAID “continues to work in partnership with the DoH, local governments and the private sector to increase access to and improve the quality of basic health services, including family planning.”

Training of nurses

HealthPRO and the DoH-attached National Center for Health Promotion (NCHP) have so far trained 607 nurses and midwives and 2,217 barangay (village) health workers in 11 pilot provinces on “interpersonal communication and counseling on family planning, and maternal and child health.”

The provinces are Bulacan, Negros Oriental, Negros Occidental, Sarangani, South Cotabato, Zamboanga del Sur, Compostela Valley, Albay, Pangasinan, Capiz and Davao del Sur.

HealthPRO and NCHP are set to train another 700 health service providers and 3,000 barangay health workers in 12 other provinces: Cagayan, Isabela, Tarlac, Nueva Ecija, Aklan, Bohol, Bukidnon, Misamis Oriental, Misamis Occidental, Agusan del Norte, Zamboanga del Norte and Zamboanga Sibugay.

The two groups plan to use “strategic communication to enhance family planning and maintain behavior change among targeted market segments in the Philippines.”

May Plano Ako, finalized in June, has the “full support” of Health Secretary Enrique Ona, said Dr. Ivanhoe Escartin, NCHP head.

Ona is scheduled to lead the launching of the program on Aug. 31 in Legazpi City while Undersecretary David Lozada and Assistant Secretary Nemesio Gaco are expected to grace similar activities in San Fernando, La Union, and Bacolod City, respectively.

Communication strategy

In a 37-page report, titled “Family Planning Behavior Change Communication Strategy,” the NCHP said: “The strategy builds on the understanding that encouraging individuals or couples to use family planning is a process, involving distinct audiences that need different messages and approaches.”

“Information alone is not enough to bring about behavior change among any audience. Instead, the strategy is based on a multilevel, synchronized and holistic marketing approach to family planning.”

The same report said “the approach is unique in that it focuses on increasing modern contraceptive use through demand generation, or increasing knowledge and forming positive attitudes toward contraceptive use and birth spacing; social marketing, or repackaging or selling the concept of family planning as a lifestyle that contributes to better quality of life; and service marketing, or building capacity of family-planning service providers and promoting model providers.”

Lost opportunities

The report also noted that previous family planning approaches of the DoH had “resulted in lost opportunities to involve men and young people and address values that may actually drive contraceptive use.”

Citing data from the National Demographic and Health Survey and the Commission on Population, among others, the NCHP said that:

Many poor Filipino women are having more children than they want.

“Currently, the total number of children a Filipino woman has during her reproductive years is one child higher than the desired number, or 3.3 vs. 2.4. For the poorest women, it is two children (5.2) higher than the desired number.”

A large proportion of married women, especially those with more than two children want no more kids, yet contraceptive use is low.

“More than half (54 percent) of married women in the Philippines want no more children. The proportion of women who no longer want additional children increases with the number of living children.”

“However, contraceptive use is low and has remained fairly stagnant over the last five years. Only one out of three married women is using a family planning method and only one out of three is using a modern method.”

Unmet need

Adolescents, those aged 15 to 19, have the “highest unmet need for family planning.”

The DoH defines “unmet need” as “the percentage of married women who either want to stop having children or want to wait for their next birth but are not using any family planning method.”

More than one in five pregnancies in the country are either mistimed or unwanted.

Worse, “many women obtain an abortion when they discover an unplanned pregnancy.”

“About one in five pregnancies in the Philippines end up in illegal abortions, mostly in unsafe conditions that can lead to maternal deaths.”

In a May Plano Ako briefing paper, HealthPRO said “many Filipinos believe having a plan is good for their families.”

“They not only want their government to help them plan their families. They also have to get the information and services they need to help them plan their families,” HealthPRO also said.

Aside from HealthPRO, USAID’s other health-related projects in the country include SHIELD, short for Sustainable Health Improvement Through Empowerment and Local Development; Health Policy Development Program (HPDP); Private Sector Mobilization for Family Health (PRISM); and Strengthening Local Governance for Health (HealthGov).

These projects are part of the US government’s “Country Assistance Strategy for the Philippines” from 2009 to 2013.

P4.46B in USAID projects

Last year, the USAID allocated $96.04 million (about P4.46 billion) to its projects in the Philippines.

Nearly $27 million (about P1.25 billion) of the budget was spent on health-related projects like the drive against HIV-AIDS, tuberculosis and other infectious diseases.

In June, then Health Secretary Esperanza Cabral cited the USAID as a DoH partner in the state’s family planning campaign.

Earlier in an interview, Cabral told the Inquirer that the government’s family planning program had “not been as successful as we want it to be.”

“Even as population growth is coming down, it is not coming down at the rate necessary to improve the country’s socioeconomic status,” she said.

Target growth rate

Cabral said the state needed to “bring it down (from 2.04 percent in 2008) to a level of 1.3 to 1.4 percent per annum where the population will stabilize.”

In a report on the Philippines, the UN Millennium Campaign (on the MDGs) said “the country’s high population growth is diluting the gains of economic growth.”

“The larger the population a country has, the greater will be the pressure on basic social services and on natural resources,” it said.

Here, “more than one million babies are born every year. They will be needing resources in the future, such as health care, schooling, food, clothing and later on, employment. Even today, these needs are not being met,” the report added. –Jerry E. Esplanada, Philippine Daily Inquirer